Gundersen, Bruce Van
Gundersen, Bruce Van is an sole proprietor health care provider with primary practice located at 4211 Holladay Blvd , Salt Lake City UT 84124-2607. He recently has only one registered license in Chiropractic Providers / Orthopedic, which is considered as his primary health care specialty. Gundersen, Bruce Van can be contacted via phone (801) 272-8471.Contact Information
Primary practice address
4211 Holladay Blvd
Salt Lake City UT 84124-2607
Phone: (801) 272-8471
Fax: (801) 424-2219
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Orthopedic | 111NX0800X | 161820-1202 | Utah |
Profile Details
| NPI number | 1952409476 |
|---|---|
| LBN Legal business name | Gundersen, Bruce Van |
| Credentials | DC, FACO |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952409476 | NPPES |
| Utah | MEDICAID | 870395551005 | |
| Utah | Other | 161820-1202 |
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